Contrast dye and renal failure

[kickingandscreaming]

In my future I am looking at possible eventual heart surgery (Watchman Implant).  The procedure involves several uses of contrast dye.  This scares me a lot.  Does anyone here --in kidney failure--have experience with the use of dye?









6/9/18 Edited - Spelling in title - CharlieB53

[Simon Dog]

Ask your nephrologist.   If you kidneys are gone to the point of needing dialysis, there may not be much to lose.

As to healthy kidneys - contrast-induced neuropathy is very real, but usually reversible.

[Cupcake]

I assume it's similar contrast to cardiac Cath so could be devastating. If you still have residual kidney function, (pee) don't trust the cardiologists. Ask your nephrologist for sure. If your kidney function is completely toast, well then probably not gonna matter.

[Michelle2016]

Usually they will schedule dialysis right after the procedure.

[Charlie B53]

Have a talk with the Cardiac Surgeon.  My Dr at the VA Hospital uses CO2 instead of dye for the tests.  CO2 shows well on the x-rays and is readily absorbed and dispelled by the body without damaging anything.

I was amazed.

[Michael Murphy]

I’ve had 2 angioplasties prior to Dialysys and two after.  The first two the cardiologist took pains to minimize the amount of dye and the next 2 took place after a widow maker heart attack.  In those two the cardiologist was attempting to save my life so more dye was used and I suffered a major decline in urine output.  Without those two angioplasties I would have most certainly be dead.  Do I miss the output I lost yes I do but I would have been more annoyed being dead. My advise is to have your nephrologist speak to the cardiologist and let them worry.  If it’s just a angiogram there is less dye involved then in a angioplasty.  Good Luck.

[kickingandscreaming]

It's not "just" an angioplasty.  It's a technique that requires inserting a catheter in the groin that leads to the heart.  The process is guided by the dye.

https://youtu.be/1f33kyMh9rM

[sahern]

I had the procedure done after almost two years of PD.  There was a lot more die used than before I started dialysis.  I made sure to drink more water than normal for me and had no ill effects from the dye.  Labs stayed the same and urine output did not change.

[GA_DAWG]

The only thing they have ever asked me is if I am allergic to the contrast dye. They use it doing declots.

[Simon Dog]

If you have a cardiac angioplasty done, make sure the cath lab is set up to do stenting (maybe they all are nowadays).   You don't want to hear "you need a stent, go to the big city and have this done again".

When they go in through the groin (femoral artery), they generally keep you for a day and will often run a normal saline IV to flush the dye, assuming renal function.

[Jean]

I have had a really bad time, trying to get my annual scan for my Aortic Aneurysm. Fortunately I went to see the neph  last week and just happened to mention this problem ( getting the scan) He just very firmly shook his head and said " no contrast dyes of any kind". I thought that since I am 4th stage, it would be okay. I thought wrong. So, finally, I was approved for a scan appropriate to my needs Once I get past this, I can get to see the pain specialist, as he would not even look at me until it was either done or the surgery for the aneurysm is done. Only been waiting since Dec. 15th or so of 2017.

[MooseMom]

Jean, I did not know you have an aortic aneurysm.  For how long have you had it?  Do you know?  Did you have any symptoms, or did your doctors just happen to find it during a routine check up of some   sort?  Are the annual scans done just to determine at what point you will need to have it repaired?

My mother had an aortic aneurysm, and at the same time, she had switched PCPs and had gone for her annual checkup.  It showed some sort of renal deterioration, the kind of which I could never find out.  My mother was not the best at understanding medical stuff.  Anyway, she had been pumped full of dye, and I am convinced to this day that it didn't help her kidneys.  I don't think her doctors took very good care of her; I think they ignored her possible kidney issues (again, which were never really defined but still seemed to be present).

Anyway, my point is that I am SO GLAD that you happened to mention this to your neph and that he has taken good care of you.  When do you think your scan will take place.  And you've been having to wait to see a pain specialist for your neuropathy since December?  That's dreadful.  I'm really sorry to hear this. 

[GA_DAWG]

I am convinced that untreated neuropathy is at least a small portion of the opioid epidemic. When people cannot get treatment, for what is really excessive pain just from moving, they are going to seek what alternatives they can find.

[Jean]

MM, I have had it for about 5 years and it has not grown at all. It was 3.9 when they found it during an x-ray for something else. At any rate, I have had the same scan once a year and there was no change until this year and the Dr. wanted to examine it closer and requested this scan that is done with as she said a contrast dye to save my kidneys. Good thing I mentioned it to my Neph. As soon as I got home I called the Dr. and left a message and in two days got the authorization and a polite phone call for a change. My Father had one and it ruptured and he died. As far as I know my brother did not have one, however he did have a bad heart and tons of surgeries for that. The Dr's all say when the aneurysm get to 5.0 it comes out and I guess they are looking at it now. I hope so, I would rather it be taken out than rupture. Thank you for your very kind remarks, they are much appreciated. 

[MooseMom]

Thanks for all of the information, Jean.  I know I can get very tedious with all of my questions, so I appreciate your replies. 

If you don't mind, I would really like to hear the results of the scan once you have them.  I'm glad your Dr. followed up on the info from your neph.  Doctors really should make more of an effort to communicate with each other instead of relying on patients to be the go-betweens, you know?

Take care of yourself!!

[Athena]

Contrast dyes is something I've been advised is a definite 'no no' for anyone with pre-dialysis CKD. It definitely is a widely known risk factor amongst nephrologists. Other specialists are notorious for ignoring (or not being fully aware of) the danger they present to renal patients.

What Charlie said about CO2 gases being used instead of contrast dyes is very interesting & sounds like something to enquire further about.

Charlie do you have more info on this at all?

[Simon Dog]

I generally run any prescription from any other MD by my nephrologist for approval.  He's very responsive to email queries, and is always very willing to give his opinion on RXes from other MDs.

[Charlie B53]

Contrast dyes is something I've been advised is a definite 'no no' for anyone with pre-dialysis CKD. It definitely is a widely known risk factor amongst nephrologists. Other specialists are notorious for ignoring (or not being fully aware of) the danger they present to renal patients.

What Charlie said about CO2 gases being used instead of contrast dyes is very interesting & sounds like something to enquire further about.

Charlie do you have more info on this at all?

I've had a number of angio's at the VA since my kidneys have gone bad, ALL have been done using CO2 instead of dye.

I'm just the patient, the Dr's know far more than me.  I was amazed that someone had the idea of using CO2 and that it works so well.

[Athena]

Contrast dyes is something I've been advised is a definite 'no no' for anyone with pre-dialysis CKD. It definitely is a widely known risk factor amongst nephrologists. Other specialists are notorious for ignoring (or not being fully aware of) the danger they present to renal patients.

What Charlie said about CO2 gases being used instead of contrast dyes is very interesting & sounds like something to enquire further about.

Charlie do you have more info on this at all?

I've had a number of angio's at the VA since my kidneys have gone bad, ALL have been done using CO2 instead of dye.

I'm just the patient, the Dr's know far more than me.  I was amazed that someone had the idea of using CO2 and that it works so well.

That truly sounds like a much better alternative to contrast dye, Charlie! I'll be sure to raise this in my next consultation with my gastro-intestitinal guy. Thanks!

[kickingandscreaming]

I recently had a echo cardiagram (ultrasound) and the technician added a small amount of fat to make the "picture" clearer.  Can't remember how she added the fat, but she did.

What I'm in store for is a heart procedure that requires sending a scope up vein in the groin all the way up to the heart.  This requires dye, I believe, or I won't be eligible for it.

[Simon Dog]

What I'm in store for is a heart procedure that requires sending a scope up vein in the groin all the way up to the heart.  This requires dye, I believe, or I won't be eligible for it.

They don't send a scope, but a tube that can inject the contrast dye.    If you get the deluxe treatment, they will have a balloon on the end and a stent that can be expanded in place if necessary.   The visualization is from a real-time x-ray that views the radioopaque due injected by the tube.

Also, I think they use the femoral artery rather than a vein.